1
|
Kakamu T, Ito T, Endo S, Hidaka T, Masuishi Y, Kasuga H, Fukushima T. Inappropriate timing of salt intake increases the risk of heat-related illness: An observational study. PLoS One 2024; 19:e0296388. [PMID: 38165857 PMCID: PMC10760686 DOI: 10.1371/journal.pone.0296388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 12/12/2023] [Indexed: 01/04/2024] Open
Abstract
The importance of salt intake in preventing heat-related illness (HRI) is well established, however, the specific method of ingestion has not been sufficiently studied. This study, therefore, aimed to investigate the optimal timing of salt intake to prevent HRI during hot outdoor work. We recruited 28 healthy male firefighters working at a fire department in Japan. They were provided a questionnaire to complete before and after receiving training in the summer season. We assessed their salt intake as before, during, and after training or none. In addition, they completed a brief self-administered diet history questionnaire to evaluate their daily salt and alcohol intake. HRI was determined through subjective and objective symptoms listed in the questionnaire, and environmental data were obtained from a national database. Subsequently, factors related to HRI were determined using a logistic regression model. The mean age of the participants was 31.0 ± 7.7 years. The study was performed within 250 working days, and we detected 28 HRI symptoms (11.2%). The median alcohol intake was 25.6 g/day when calculated according to the actual work system. Logistic mixed effect model analysis revealed that salt intake before training (OR: 5.893, 95% CI: 1.407-24.675), and salt intake before and during training (OR: 22.889, 95% CI: 4.276-122.516) were positively associated with HRI symptoms. The results indicate that inappropriate timing of salt intake increases the risks of HRI. Thus, a timely intake of salt in adequate amounts may be important in preventing these risks.
Collapse
Affiliation(s)
- Takeyasu Kakamu
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Teruna Ito
- Department of Food and Nutrition, Koriyama Women’s University, Koriyama, Fukushima, Japan
| | - Shota Endo
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Tomoo Hidaka
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Yusuke Masuishi
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Hideaki Kasuga
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Tetsuhito Fukushima
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Fukushima, Japan
| |
Collapse
|
2
|
Mbosso Teinkela JE, Nguemfo EL, Fokou Nzodjou T, Bogning Zangueu C, Kalinski JC, Tsakem B, Assob Nguedia JC, Siwe Noundou X. Antihypertensive potential of the stem bark of Canarium schweinfurthii Engl. (Burseraceae) in wistar rats: UPLC-ESI-QToF-MS/MS-based prediction of antihypertensive phytochemicals. Heliyon 2023; 9:e21841. [PMID: 38027816 PMCID: PMC10663920 DOI: 10.1016/j.heliyon.2023.e21841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Ethnopharmacological relevance Canarium schweinfurthii, also called ''Elemierd'Afrique'', is used in Cameroonian folk medicine (bark decoction) to treat patients suffering from hypertension.Aim of the study: This study aimed at evaluating the antihypertensive activities of the stem bark of Canarium schweinfurthii and identifying potential compounds present in its extract that may support or oppose its ethnomedicinial use. Materials and methods Stem bark extract of Canarium schweinfurthii was prepared by maceration using 70 % ethanol followed by redissolution in methanol and hyphenated. Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS) analysis for the detection and characterisation of secondary metabolites. Antihypertensive effects were assessed in Wistar rats after induction of hypertension with sodium chloride (NaCl) 18 % at a dose of 0.01mL/gbody weight once a day for four weeks.Hemodynamic parameters were measured weekly by anon-invasive method using the CODA system. Results The ethanolic bark extract of C. schweinfurthii significantly inhibited the increase of blood pressure with a maximum of 23.18 % (systolic pressure, p < 0.0001), 24.77 % (diastolic pressure, p < 0.001) and 22.95 % (mean pressure, p < 0.0001) at a dose of 200 mg/kgbody weight at the 4th week, compared to agroup of Wistar rats that received only NaCl (negative control). Similarly, the extract significantly inhibited the increase in heart rate by 18.84 % (p < 0.001) at 200 mg/kgbody weight at week four. Hematological parameters did not differ significantly between the extract-treated and control groups. The UPLC-MS/MS spectrometric analysis provided evidence for the presence of several C30 terpenoids containing three or five oxygen atoms and exhibiting pentacyclic triterpenoid structures, as well as C29 terpenoids and related compounds containing nitrogen in addition to oxygen, using spectral matching, and in silico molecular formula and structure prediction. Additionally, two features were annotated with high-confidence as lignans, structurally closely related to hinokinin and dehydrocubebin through MS/MS-based in silico structure prediction using CSI: Finger ID in SIRIUS5. The lignans have been previously reported from stem bark of plants belonging to the Burseraceae family. Conclusion: The ethanolic stem bark extract of C. schweinfurthii demonstrated antihypertensive properties on the tested Wistar rats. These results support the ethnopharmacological use of C. schweinfurthii concoctions for the treatment of hypertension and suggest a protective effect against salt damage, hypothetically by the up regulation of antioxidative enzymes and/or lipids, mitigatings membrane peroxidation.
Collapse
Affiliation(s)
- Jean Emmanuel Mbosso Teinkela
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O. Box 2701 Douala, Cameroon
| | - Edwige Laure Nguemfo
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O. Box 2701 Douala, Cameroon
| | - Thierry Fokou Nzodjou
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O. Box 2701 Douala, Cameroon
| | - Calvin Bogning Zangueu
- Department of Biology and Physiology of Animal Organisms, Faculty of Sciences, University of Douala, P.O. Box 24157 Douala, Cameroon
| | - Jarmo-Charles Kalinski
- Department of Biochemistry and Microbiology, Faculty of Science, Rhodes University, Makhanda 6140, South Africa
| | - Bienvenu Tsakem
- Department of Chemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Jules Clement Assob Nguedia
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, P.O. Box 2701 Douala, Cameroon
| | - Xavier Siwe Noundou
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, P.O. Box 60, Pretoria 0204, South Africa
| |
Collapse
|
3
|
Jung JY, Oh CM, Kim E, Park SK. Dietary sodium intake and its relation to sleep duration, sleep quality and nocturnal urination in working-aged Korean adults. NUTR BULL 2023; 48:365-375. [PMID: 37458133 DOI: 10.1111/nbu.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/13/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Both sodium intake and sleep have an important effect on cardiovascular health. However, few studies have looked at the association between sodium intake and sleep. Therefore, we analysed the association of sodium intake with sleep quality, sleep duration and nocturnal urination. The data for the present study were obtained from the Kangbuk Samsung Health Study. Study participants were 156 696 working-aged Korean adults (average age 38.0 years ±8.0 in men and 36.0 years ±8.1 in women). They were categorised into five groups by quintile of sodium intake, measured by food frequency questionnaire. Poor sleep quality and short sleep duration were determined by Pittsburgh Sleep Quality Index >5, and sleep duration <7 h, respectively. Nocturnal urination was defined as awakening to urinate more than three times a week. Multivariable adjusted logistic regression analysis was used in calculating the odds ratio (OR) and 95% confidence interval (CI) for poor sleep quality, short sleep duration and nocturnal urination (adjusted OR [95% CI]) across five study groups. In all study participants, increased sodium intake was significantly associated with poor sleep quality (quintile 1: reference, quintile 2: 1.07 [1.04-1.11], quintile 3: 1.12 [1.08-1.16], quintile 4: 1.15 [1.11-1.19] and quintile 5: 1.13 [1.09-1.18]). This pattern of relationship was similarly observed in association of sodium intake with short sleep duration (p for trend <0.001) and nocturnal urination (p for trend <0.001). In gender subgroup analysis, increased sodium intake had a significant association with poor sleep quality and short sleep duration in men and with poor sleep quality and nocturnal urination in women. In conclusion, high sodium intake is associated with an increased likelihood of poor sleep quality, short sleep duration and nocturnal urination.
Collapse
Affiliation(s)
- Ju Young Jung
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chang-Mo Oh
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Eugene Kim
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Keun Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| |
Collapse
|
4
|
Simon Y, Jacques D, Bkaily G. High salt-induced morphological and glycocalyx remodeling of human vascular smooth muscle cells is reversible but induces a high sodium salt-like sensitive memory. Can J Physiol Pharmacol 2023; 101:437-446. [PMID: 37290125 DOI: 10.1139/cjpp-2023-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Our recent work showed that short-term treatment (1-2 days) with high sodium salt had no effect on the morphology of human vascular smooth muscle cells (hVSMCs). However, chronic (long-term treatment, 6-16 days) high sodium salt (CHSS) induced hypertrophy and decreased the relative density of the glycocalyx in hVSMCs. Whether this CHSS effect is reversible at both the morphological and the intracellular calcium and sodium levels is unknown. In the present study, we tested the hypothesis that the effect of CHSS on the morphological and functional levels of hVSMCs is reversible. However, it induced an irreversible increase in the sensitivity of the cells following short-term treatment with high extracellular Na+. We tested the effects of the removal of CHSS treatment on the morphology and intracellular sodium and calcium of hVSMCs. Our results showed that restoring average sodium concentration (145 mM) modeled back the relative density of the glycocalyx, the intracellular resting calcium and sodium levels, and the whole cell and nuclear volumes of hVSMCs. In addition, it induced a permanent remodeling of hVSMCs' response to a short-term increase in the extracellular level of sodium salt by developing spontaneous cytosolic and nuclear calcium waves. Our results showed that CHSS is reversible at both the morphological and basal intracellular ionic levels. However, it maintained a high sensitivity to short-term elevation of extracellular sodium. These results suggest that even if chronic high salt is corrected, it induces a high sodium salt-like sensitive memory.
Collapse
Affiliation(s)
- Yanick Simon
- Department of immunology and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Danielle Jacques
- Department of immunology and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Ghassan Bkaily
- Department of immunology and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| |
Collapse
|
5
|
Sánchez-Lozada LG, Madero M, Mazzali M, Feig DI, Nakagawa T, Lanaspa MA, Kanbay M, Kuwabara M, Rodriguez-Iturbe B, Johnson RJ. Sugar, salt, immunity and the cause of primary hypertension. Clin Kidney J 2023; 16:1239-1248. [PMID: 37529651 PMCID: PMC10387395 DOI: 10.1093/ckj/sfad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 08/03/2023] Open
Abstract
Despite its discovery more than 150 years ago, the cause of primary hypertension remains unknown. Most studies suggest that hypertension involves genetic, congenital or acquired risk factors that result in a relative inability of the kidney to excrete salt (sodium chloride) in the kidneys. Here we review recent studies that suggest there may be two phases, with an initial phase driven by renal vasoconstriction that causes low-grade ischemia to the kidney, followed by the infiltration of immune cells that leads to a local autoimmune reaction that maintains the renal vasoconstriction. Evidence suggests that multiple mechanisms could trigger the initial renal vasoconstriction, but one way may involve fructose that is provided in the diet (such as from table sugar or high fructose corn syrup) or produced endogenously. The fructose metabolism increases intracellular uric acid, which recruits NADPH oxidase to the mitochondria while inhibiting AMP-activated protein kinase. A drop in intracellular ATP level occurs, triggering a survival response. Leptin levels rise, triggering activation of the sympathetic central nervous system, while vasopressin levels rise, causing vasoconstriction in its own right and stimulating aldosterone production via the vasopressin 1b receptor. Low-grade renal injury and autoimmune-mediated inflammation occur. High-salt diets can amplify this process by raising osmolality and triggering more fructose production. Thus, primary hypertension may result from the overactivation of a survival response triggered by fructose metabolism. Restricting salt and sugar and hydrating with ample water may be helpful in the prevention of primary hypertension.
Collapse
Affiliation(s)
- Laura G Sánchez-Lozada
- Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología “Ignacio Chavez”, Mexico City, Mexico
| | - Magdalena Madero
- Division of Nephrology, Department of Medicine, Instituto Nacional de Cardiología “Ignacio Chavez”, Mexico City, Mexico
| | - Marilda Mazzali
- Division of Nephrology, University of Campinas, São Paulo, Brazil
| | - Daniel I Feig
- Division of Pediatric Nephrology, University of Alabama, Birmingham, AL, USA
| | | | - Miguel A Lanaspa
- Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Mehmet Kanbay
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | | | - Bernardo Rodriguez-Iturbe
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City
| | - Richard J Johnson
- Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| |
Collapse
|
6
|
Tampe D, Baier E, Hakroush S, Tampe B. Serum sodium levels associate with recovery of kidney function in immune checkpoint inhibitor nephrotoxicity. Front Med (Lausanne) 2023; 10:1020691. [PMID: 37547603 PMCID: PMC10399621 DOI: 10.3389/fmed.2023.1020691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Background Immune checkpoint inhibitors (ICIs) are novel drugs targeting programmed cell death protein 1-ligand 1 (PD-L1) or its receptor (PD-1). Enhancing the immune system has also been associated with a wide range of immune-related adverse events (irAE). Among them, acute interstitial nephritis (AIN) is a rare but deleterious irAE in the kidney. However, determinants of recovery and long-term kidney function after ICI withdrawal and steroid therapy thereafter remain elusive. Therefore, we here aimed to identify parameters associated with recovery of kidney function in this previous established cohort of AIN in the context of ICI therapy. Methods We here monitored kidney function over a mean follow-up time of 812 days in comparison with clinical, histopathological and laboratory parameters associated with recovery of kidney function after AIN related to ICI nephrotoxicity. Results Abundance of intrarenal PD-L1/PD-1 did not correlate with recovery of kidney function. Furthermore, cumulative steroid dose that was initiated for treatment of AIN related to ICI nephrotoxicity was also not associated with improvement of kidney function. Finally, chronic lesions in the kidney including glomerular sclerosis and interstitial fibrosis/tubular atrophy (IF/TA) did not correlate with eGFR change during the follow-up time. However, we here identified that lower levels of serum sodium at time of kidney biopsy were the strongest independent predictor of renal recovery in ICI-related nephrotoxicity. Conclusion Because low serum sodium levels associated with better improvement of kidney function, these observations might contribute to novel approaches to enhance recovery after AIN related to ICI nephrotoxicity.
Collapse
Affiliation(s)
- Désirée Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Eva Baier
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Samy Hakroush
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
- SYNLAB Pathology Hannover, SYNLAB Holding Germany, Augsburg, Germany
| | - Björn Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| |
Collapse
|
7
|
Kang EJ, Prager O, Lublinsky S, Oliveira-Ferreira AI, Reiffurth C, Major S, Müller DN, Friedman A, Dreier JP. Stroke-prone salt-sensitive spontaneously hypertensive rats show higher susceptibility to spreading depolarization (SD) and altered hemodynamic responses to SD. J Cereb Blood Flow Metab 2023; 43:210-230. [PMID: 36329390 PMCID: PMC9903222 DOI: 10.1177/0271678x221135085] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Spreading depolarization (SD) occurs in a plethora of clinical conditions including migraine aura, delayed ischemia after subarachnoid hemorrhage and malignant hemispheric stroke. It describes waves of near-breakdown of ion homeostasis, particularly Na+ homeostasis in brain gray matter. SD induces tone alterations in resistance vessels, causing either hyperperfusion in healthy tissue; or hypoperfusion (inverse hemodynamic response = spreading ischemia) in tissue at risk. Observations from mice with genetic dysfunction of the ATP1A2-encoded α2-isoform of Na+/K+-ATPase (α2NaKA) suggest a mechanistic link between (1) SD, (2) vascular dysfunction, and (3) salt-sensitive hypertension via α2NaKA. Thus, α2NaKA-dysfunctional mice are more susceptible to SD and show a shift toward more inverse hemodynamic responses. α2NaKA-dysfunctional patients suffer from familial hemiplegic migraine type 2, a Mendelian model disease of SD. α2NaKA-dysfunctional mice are also a genetic model of salt-sensitive hypertension. To determine whether SD thresholds and hemodynamic responses are also altered in other genetic models of salt-sensitive hypertension, we examined these variables in stroke-prone spontaneously hypertensive rats (SHRsp). Compared with Wistar Kyoto control rats, we found in SHRsp that electrical SD threshold was significantly reduced, propagation speed was increased, and inverse hemodynamic responses were prolonged. These results may have relevance to both migraine with aura and stroke.
Collapse
Affiliation(s)
- Eun-Jeung Kang
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ofer Prager
- Department of Physiology & Cell Biology, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Svetlana Lublinsky
- Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ana I Oliveira-Ferreira
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Clemens Reiffurth
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sebastian Major
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité - Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Alon Friedman
- Department of Physiology & Cell Biology, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Medical Neuroscience and Brain Repair Center, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jens P Dreier
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany.,Einstein Center for Neurosciences Berlin, Berlin, Germany
| |
Collapse
|
8
|
Yu J, Zhu H, Kindy MS, Taheri S. The impact of a high-sodium diet regimen on cerebrovascular morphology and cerebral perfusion in Alzheimer's disease. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 4:100161. [PMID: 36741272 PMCID: PMC9895990 DOI: 10.1016/j.cccb.2023.100161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/05/2022] [Accepted: 01/27/2023] [Indexed: 01/30/2023]
Abstract
Introduction Various lifestyle factors such as chronic hypertension and a high-sodium diet regimen are shown to impact cerebrovascular morphology and structure. Unusual cerebrovascular morphological and structural changes may contribute to cerebral hypoperfusion in Alzheimer's disease (AD). The objective of this study was to examine whether a high-sodium diet mediates cerebrovascular morphology and cerebral perfusion alterations in AD. Methods Double transgenic mice harboring Aβ precursor protein (APPswe) and presenilin-1 (PSEN1) along with wild-type controls were divided into four groups. Group A (APP/PS1) and B (controls) were both fed a high-sodium (4.00%), while group C (APP/PS1) and D (controls) were both fed a low-sodium (0.08% a regular chow diet) for three months. Then, changes in regional cerebral perfusion and diffusion, cerebrovascular morphology, and structure were quantified. Results A 3-month high-sodium diet causes pyknosis and deep staining in hippocampal neurons and reduced vascular density in both hippocampal and cortical areas (p <0.001) of APP/PS1. Despite vascular density changes, cerebral perfusion was not increased markedly (p = 0.3) in this group, though it was increased more in wild-type controls (p = 0.022). Conclusion A high-sodium diet regimen causes cerebrovascular morphology alteration in APP/PS1 mouse model of AD.
Collapse
Affiliation(s)
- Jin Yu
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Hong Zhu
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Mark S. Kindy
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA,James A. Haley VA Medical Center, Tampa, FL 33612, USA
| | - Saeid Taheri
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA,USF Heart Institute, Tampa, FL 33612, USA,Corresponding author at: Department of Pharmaceutical Sciences, USF Heart Institute, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 30, Tampa, FL 33612, USA.
| |
Collapse
|
9
|
Cheng Q, Liu X, Cai A, Zhou D, Huang Y, Feng Y. Serum sodium level is inversely associated with new-onset diabetes in hypertensive patients. J Diabetes 2022; 14:831-839. [PMID: 36470584 PMCID: PMC9789394 DOI: 10.1111/1753-0407.13338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/25/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Serum sodium level is associated with cardiovascular and endocrine health. Though decreased serum sodium is considered to be associated with reduced hypertension risk, some studies also found that it may increase the risk of diabetes. This study aimed to investigate the association of serum sodium with new-onset diabetes in hypertensive patients. METHODS Based on the annual health examinations from 2011 to 2016 in Dongguan City, Guangdong, China, hypertensive patients without diabetes at baseline were selected. Logistic regression and restricted cubic spline were used to evaluate the association between serum sodium level and new-onset diabetes. Subgroup analysis was also conducted. RESULTS A total of 4438 hypertensive patients with a mean age of 58.65 years were included, of whom 48.9% were male. During a median follow-up of 35.1 months, 617 (13.9%) of the subjects developed new-onset diabetes. Per 1-SD (3.39 mmol/L) increment of serum sodium was associated with a 14% lower risk of new-onset diabetes (odds ratio = 0.86; 95% CI: 0.78, 0.97; p = 0.01). The lowest quartile of serum sodium was associated with the lowest diabetes risk. The restricted cubic spline showed a linear inverse relationship (nonlinear p = 0.72). Across all the subgroups, the inverse association was consistent (p for interaction >0.05). CONCLUSION An inverse association of serum sodium with new-onset diabetes in hypertensive patients was observed.
Collapse
Affiliation(s)
- Qi Cheng
- Department of CardiologyGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
- Hypertension Research Laboratory, Guangdong Provincial Clinical Research Center for Cardiovascular DiseaseGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Xiaocong Liu
- Department of CardiologyGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
- Hypertension Research Laboratory, Guangdong Provincial Clinical Research Center for Cardiovascular DiseaseGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Anping Cai
- Department of CardiologyGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
- Hypertension Research Laboratory, Guangdong Provincial Clinical Research Center for Cardiovascular DiseaseGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Dan Zhou
- Department of CardiologyGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
- Hypertension Research Laboratory, Guangdong Provincial Clinical Research Center for Cardiovascular DiseaseGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Yuqing Huang
- Department of CardiologyGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
- Hypertension Research Laboratory, Guangdong Provincial Clinical Research Center for Cardiovascular DiseaseGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| | - Yingqing Feng
- Department of CardiologyGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
- Hypertension Research Laboratory, Guangdong Provincial Clinical Research Center for Cardiovascular DiseaseGuangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouGuangdongChina
| |
Collapse
|
10
|
The Relationship between the Plasma Concentration of Electrolytes and Intensity of Sleep Bruxism and Blood Pressure Variability among Sleep Bruxers. Biomedicines 2022; 10:biomedicines10112804. [PMID: 36359324 PMCID: PMC9687451 DOI: 10.3390/biomedicines10112804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Plasma sodium plays a major role in regulating blood pressure (BP). An augmented variability of BP is considered a risk factor for the development of arterial hypertension, which is prevalent among patients with suspected sleep bruxism (SB). The aims of this study were to assess the plasma concentration of electrolytes and their effect on the intensity of SB and BP variability among sleep bruxers. A total of 51 patients were enrolled in this prospective, observational study. A single full-night polysomnographic examination was conducted in the Wroclaw Medical University Sleep Laboratory, Poland, and based on the guidelines of the American Academy of Sleep Medicine, the results were analyzed. The monitoring of ambulatory BP was performed the next day, and the plasma levels of sodium, potassium, magnesium, and calcium were measured. The mean age of the studied group was 33.9 ± 11.2 years, and the mean bruxism episode index (BEI) was 4.94 ± 3.53. The study revealed statistically significant differences in the plasma concentrations of sodium in the SB group. A decreased sodium concentration was observed in the group of mild bruxers (2 ≤ BEI < 4) (139.7 ± 1.4 vs. 142.8 ± 3.2, p = 0.002) and severe bruxers (BEI ≥ 4) (140.5 ± 2.0 vs. 142.8 ± 3.2, p = 0.016) compared to nonbruxers (BEI < 2). A statistically significant positive linear correlation was found between plasma sodium concentration and daytime systolic BP variability (r = 0.32, p < 0.05) as well as between plasma sodium concentration and nighttime diastolic BP variability (r = 0.31, p < 0.05). The preliminary results suggest the probable relationship between the lower plasma concentration of sodium and increased intensity of SB and BP variability among suspected sleep bruxers.
Collapse
|
11
|
CLINICOPATHOLOGIC EVALUATION OF AN EX SITU POPULATION OF ADULT AFRICAN WHITE-BELLIED PANGOLIN (PHATAGINUS TRICUSPIS). J Zoo Wildl Med 2022; 53:551-560. [DOI: 10.1638/2021-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/21/2022] Open
|
12
|
Graphene-Based Ion-Selective Field-Effect Transistor for Sodium Sensing. NANOMATERIALS 2022; 12:nano12152620. [PMID: 35957055 PMCID: PMC9370261 DOI: 10.3390/nano12152620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022]
Abstract
Field-effect transistors have attracted significant attention in chemical sensing and clinical diagnosis, due to their high sensitivity and label-free operation. Through a scalable photolithographic process in this study, we fabricated graphene-based ion-sensitive field-effect transistor (ISFET) arrays that can continuously monitor sodium ions in real-time. As the sodium ion concentration increased, the current–gate voltage characteristic curves shifted towards the negative direction, showing that sodium ions were captured and could be detected over a wide concentration range, from 10−8 to 10−1 M, with a sensitivity of 152.4 mV/dec. Time-dependent measurements and interfering experiments were conducted to validate the real-time measurements and the highly specific detection capability of our sensor. Our graphene ISFETs (G-ISFET) not only showed a fast response, but also exhibited remarkable selectivity against interference ions, including Ca2+, K+, Mg2+ and NH4+. The scalability, high sensitivity and selectivity synergistically make our G-ISFET a promising platform for sodium sensing in health monitoring.
Collapse
|
13
|
Tamás P, Kovács K, Várnagy Á, Farkas B, Alemu Wami G, Bódis J. Preeclampsia subtypes: Clinical aspects regarding pathogenesis, signs, and management with special attention to diuretic administration. Eur J Obstet Gynecol Reprod Biol 2022; 274:175-181. [PMID: 35661540 DOI: 10.1016/j.ejogrb.2022.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/18/2022] [Accepted: 05/27/2022] [Indexed: 11/04/2022]
Abstract
During normal pregnancy, blood volume increases by nearly two liters. Distinctively, the absence coupled with the extreme extent regarding the volume expansion, are likely accompanied with pathological conditions. Undoubtedly, preeclampsia, defined as the appearance of hypertension and organ deficiency, such as proteinuria during the second half of pregnancy, is not a homogenous disease. Clinically speaking, two main types of preeclampsia can be distinguished, in which a marked difference between them is vascular condition, and consequently, the blood volume. The "classic" preeclampsia, as a two-phase disease, described in the first, latent phase, in which, placenta development is diminished. Agents from this malperfused placenta generate a maternal disease, the second phase, in which endothelial damage leads to hypertension and organ damage due to vasoconstriction and thrombotic microangiopathy. In this hypovolemia-associated condition, decreasing platelet count, signs of hemolysis, renal and liver involvement are characteristic findings; proteinuria is marked and increasing. In the terminal phase, visible edema develops due to increasing capillary transparency, augmenting end-organ damages. "Classic" preeclampsia is a severe and quickly progressing condition with placental insufficiency and consequent fetal growth restriction and oligohydramnios. The outcome of this condition often leads to fetal hypoxia, eclampsia or placental abruption. The management is limited to a diligent prolongation of pregnancy to accomplish improved neonatal pulmonary function, careful diminishing high blood pressure, and delivery induction in due time. The other subtype, associated with relaxed vasculature and high cardiac output, is a maternal disease, in which obesity is an important risk factor since predisposes to enhanced water retention, hypertension, and a weakened endothelial dysfunction. Initially, enhanced water retention leads to lowered extremity edema, which oftentimes progresses to a generalized form and hypertension. In several cases, proteinuria appears most likely due to tissue edema. This condition already fully meets preeclampsia criteria. Laboratory alterations, including proteinuria, are modest and platelet count remains within the normal range. Fetal weight is also normal or frequently over average due to enhanced placental blood supply. It is very likely, further water retention leads to venous congestion, a parenchyma stasis, responsible for ascites, eclampsia, or placental abruption. During the management of this hypervolemia-associated preeclampsia, the administration of diuretic furosemide treatment seemingly offers promise.
Collapse
Affiliation(s)
- Péter Tamás
- National Laboratory for Human Reproduction, University of Pécs, Pécs, Hungary; Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary; Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary; Institute of Emergency Care and Pedagogy of Health, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
| | - Kálmán Kovács
- National Laboratory for Human Reproduction, University of Pécs, Pécs, Hungary; Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary; Hungarian Academy of Sciences - University of Pécs Human Reproduction Scientific Research Group, University of Pécs, Pécs, Hungary
| | - Ákos Várnagy
- National Laboratory for Human Reproduction, University of Pécs, Pécs, Hungary; Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary; Hungarian Academy of Sciences - University of Pécs Human Reproduction Scientific Research Group, University of Pécs, Pécs, Hungary
| | - Bálint Farkas
- National Laboratory for Human Reproduction, University of Pécs, Pécs, Hungary; Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary; Hungarian Academy of Sciences - University of Pécs Human Reproduction Scientific Research Group, University of Pécs, Pécs, Hungary
| | - Girma Alemu Wami
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - József Bódis
- National Laboratory for Human Reproduction, University of Pécs, Pécs, Hungary; Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary; Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary; Hungarian Academy of Sciences - University of Pécs Human Reproduction Scientific Research Group, University of Pécs, Pécs, Hungary
| |
Collapse
|
14
|
Swift SL, Drexler Y, Sotres-Alvarez D, Raij L, Llabre MM, Schneiderman N, Horn LV, Lash JP, Mossavar-Rahmani Y, Elfassy T. Associations of sodium and potassium intake with chronic kidney disease in a prospective cohort study: findings from the Hispanic Community Health Study/Study of Latinos, 2008-2017. BMC Nephrol 2022; 23:133. [PMID: 35387601 PMCID: PMC8988326 DOI: 10.1186/s12882-022-02754-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND According to dietary recommendations, reduction of sodium intake has potential to reduce Chronic Kidney Disease (CKD) risk; however the role of dietary potassium and the sodium -to- potassium ratio in the development of CKD is unclear. METHODS We studied 9778 participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four US urban communities. Participants were aged 18-74 yrs., free from CKD at baseline in 2008-2011 and re-examined between 2014 and - 2017. Dietary intake of sodium, potassium and the ratio of dietary sodium -to- potassium were measured from two baseline 24-h dietary recalls. Incident CKD was defined as: 1) estimated glomerular filtration rate (eGFR) decline of 1 unit per year and eGFR < 60 ml/min/1.73m2 or 2) albumin to creatinine ratio ≥ 30 mg/g at the follow-up visit. We used multivariable survey weighted Poisson regression to estimate adjusted incident rates of incident CKD. RESULTS At baseline, mean age was 41 years. Average follow up time was 6.2 years. From fully adjusted Poisson regression analyses, self-reported sodium intake was not associated with incident CKD. However, for each 500 mg decrement in potassium intake, there was an 11% increase risk of incident CKD (IRR = 1.11, 95% CI = 1.00, 1.24). Additionally, every 1 M ratio increment of sodium -to -potassium ratio was associated with a 21% increased risk of incident CKD (IRR = 1.21, 95% CI = 1.02, 1.45), p < 0.05). CONCLUSIONS We conclude that diets low in potassium and high in sodium are associated with increased risk of developing chronic kidney disease among healthy US Hispanic/Latino adults.
Collapse
Affiliation(s)
- Samuel L Swift
- Center for Healthcare Equity in Kidney Disease, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Yelena Drexler
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leopoldo Raij
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanstown, IL, USA
| | - James P Lash
- Department of Medicine, University of Illinois College of Medicine, Chicago, IL, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Tali Elfassy
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA.
| |
Collapse
|
15
|
Tanaka S, Fujishiro M, Imatake K, Suzuki Y, Ishihara H, Tani S. Impact of Female Sex on the Susceptibility to Hypernatremia Among Older Community-Dwelling Individuals in Japan. Int J Gen Med 2022; 15:777-785. [PMID: 35082525 PMCID: PMC8786365 DOI: 10.2147/ijgm.s345150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Sho Tanaka
- Department of Internal Medicine, Nihon University Hospital, Tokyo, 101-8309, Japan
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, 173-8610, Japan
| | - Midori Fujishiro
- Department of Internal Medicine, Nihon University Hospital, Tokyo, 101-8309, Japan
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, 173-8610, Japan
- Correspondence: Midori Fujishiro, Department of Internal Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyoda-ku, Tokyo, 101-8309, Japan, Tel +81-3-3972-8111, Fax +81-3-3959-9775, Email
| | - Kazuhiro Imatake
- Department of Health Planning Center, Nihon University Hospital, Tokyo, 101-8309, Japan
| | - Yasuyuki Suzuki
- Department of Health Planning Center, Nihon University Hospital, Tokyo, 101-8309, Japan
- Department of Cardiology, Nihon University Hospital, Tokyo, 101-8309, Japan
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, 173-8610, Japan
| | - Hisamitsu Ishihara
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, 173-8610, Japan
| | - Shigemasa Tani
- Department of Health Planning Center, Nihon University Hospital, Tokyo, 101-8309, Japan
- Department of Cardiology, Nihon University Hospital, Tokyo, 101-8309, Japan
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, 173-8610, Japan
| |
Collapse
|
16
|
NODA M, MATSUDA T. Central regulation of body fluid homeostasis. PROCEEDINGS OF THE JAPAN ACADEMY. SERIES B, PHYSICAL AND BIOLOGICAL SCIENCES 2022; 98:283-324. [PMID: 35908954 PMCID: PMC9363595 DOI: 10.2183/pjab.98.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Extracellular fluids, including blood, lymphatic fluid, and cerebrospinal fluid, are collectively called body fluids. The Na+ concentration ([Na+]) in body fluids is maintained at 135-145 mM and is broadly conserved among terrestrial animals. Homeostatic osmoregulation by Na+ is vital for life because severe hyper- or hypotonicity elicits irreversible organ damage and lethal neurological trauma. To achieve "body fluid homeostasis" or "Na homeostasis", the brain continuously monitors [Na+] in body fluids and controls water/salt intake and water/salt excretion by the kidneys. These physiological functions are primarily regulated based on information on [Na+] and relevant circulating hormones, such as angiotensin II, aldosterone, and vasopressin. In this review, we discuss sensing mechanisms for [Na+] and hormones in the brain that control water/salt intake behaviors, together with the responsible sensors (receptors) and relevant neural pathways. We also describe mechanisms in the brain by which [Na+] increases in body fluids activate the sympathetic neural activity leading to hypertension.
Collapse
Affiliation(s)
- Masaharu NODA
- Homeostatic Mechanism Research Unit, Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan
- Correspondence should be addressed to: Homeostatic Mechanism Research Unit, Institute of Innovative Research, Tokyo Institute of Technology, Nagatsuta-cho 4259, Midori-ku, Yokohama, Kanagawa 226-8503, Japan (e-mail: )
| | - Takashi MATSUDA
- Homeostatic Mechanism Research Unit, Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan
| |
Collapse
|
17
|
Agbaraolorunpo F, Oloyo AK, Ogunnowo SA, Anigbogu CN, Sofola O. Effect of Angiotensin receptor blockade on Plasma Osmolality and Neurohumoral Responses to High Environmental Temperature in Rats Fed a High Salt Diet. Niger J Physiol Sci 2021; 36:149-157. [PMID: 35947735 DOI: 10.54548/njps.v36i2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 06/15/2023]
Abstract
Plasma osmolality (pOsmol) and neurohumoral signals play important roles in the pathophysiology of cardiovascular diseases. Our study investigated the effect of high environmental temperature (HET) on neurohumoral responses and pOsmol in rats fed a high salt diet (HSD), with and without angiotensin II receptor blockade (ARB), using telmisartan. Fifty-six male 8-week old Sprague-Dawley rats (95-110g) were randomly assigned into seven groups of 8 rats. These included control rats (I) fed with 0.3% NaCl diet (normal diet, ND); salt-loaded rats (II) fed with 8% NaCl (high salt) diet; ND rats (III) exposed to HET (38.5±0.5oC ) 4 hours daily per week; rats (IV) fed with 8% NaCl diet and exposed to HET daily. Others included rats (V) fed with 8% NaCl diet and treated with telmisartan (30mg/kg); ND rats (VI) exposed to HET and treated with telmisartan; rats (VI) fed with 8% NaCl diet, exposed to HET and treated with telmisartan. Plasma angiotensin II, aldosterone, vasopressin and norepinephrine (NE) concentrations were determined by ELISA technique; pOsmol from plasma K+, Na+ and Urea. HSD combined with HET in rats synergistically increased pOsmol (P<0.001) with an associated non-synergistic rise in fluid intake (P<0.001), fluid balance (P<0.001), plasma angiotensin II (P<0.01) and aldosterone (P<0.05), NE (P<0.001) and vasopressin (P<0.05) concentrations compared to control. Telmisartan did not alter pOsmol in all the treated-rats, but normalized fluid intake levels and plasma vasopressin in the rats exposed to either HSD or HEt alone. Prolonged exposure of rats to hot environment exacerbated the effect of excess dietary salt on pOsmol, with no effect on angiotensin II-mediated neurohumoral responses.
Collapse
|
18
|
van den Bosch JJJON, Hessels NR, Visser FW, Krikken JA, Bakker SJL, Riphagen IJ, Navis GJ. Plasma sodium, extracellular fluid volume, and blood pressure in healthy men. Physiol Rep 2021; 9:e15103. [PMID: 34921521 PMCID: PMC8683787 DOI: 10.14814/phy2.15103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/21/2022] Open
Abstract
In the general population we recently reported a consistent association between plasma sodium and volume markers, suggesting that individuals with higher plasma sodium have higher extracellular fluid volume (ECFV). To test this hypothesis, we analyzed the association between plasma sodium and directly measured ECFV (iothalamate distribution volume) in healthy men. Second, we studied whether plasma sodium is associated with blood pressure. We analyzed data from 70 men (age 24 ± 7 years) at the end of two 7-day periods on a low-sodium diet (LS, 50 mmol Na/24 h) and a high-sodium diet (HS, 200 mmol Na/24 h), respectively. The association of plasma sodium with blood pressure was assessed in the combined data of the different sodium intakes by linear mixed effects models. A positive univariable association between plasma sodium and ECFV was found during HS (β = 0.24, p = 0.042) and LS (β = 0.23, p = 0.058), respectively. Individual values of plasma sodium on LS and HS diet were strongly correlated (β = 0.68, p < 0.001), as were values for ECFV (β = 0.54, p < 0.001). In the combined data set plasma sodium level was significantly associated with ECFV (B [SE] = 0.10 [0.04], p = 0.02), and systolic blood pressure (SBP, B [SE] = 0.73 [0.26], p = 0.006), independent of ECFV. In conclusion, plasma sodium concentration is positively associated with ECFV on both LS and HS intake. Our data confirm and extend prior data on individual regulation of plasma sodium and suggest that this is associated with individuality of the regulation of ECFV. Finally, plasma sodium level is associated with SBP, independent of ECFV and diet.
Collapse
Affiliation(s)
- Jacqueline J. J. O. N. van den Bosch
- Department of Internal MedicineDivision of NephrologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
- Present address:
Department of OphthalmologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Niek R. Hessels
- Department of Internal MedicineDivision of NephrologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Folkert W. Visser
- Department of Internal MedicineDivision of NephrologyZorggroep TwenteAlmeloThe Netherlands
| | - Jan A. Krikken
- Department of Internal MedicineDivision of CardiologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Stephan J. L. Bakker
- Department of Internal MedicineDivision of NephrologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Ineke J. Riphagen
- Department of Laboratory MedicineUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Gerjan J. Navis
- Department of Internal MedicineDivision of NephrologyUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| |
Collapse
|
19
|
Hu H, Eguchi M, Miki T, Kochi T, Kabe I, Nanri A, Macgregor GA, Mizoue T, He FJ. Serum sodium and risk of hypertension: a cohort study. Hypertens Res 2021; 45:354-359. [PMID: 34759331 DOI: 10.1038/s41440-021-00797-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/24/2021] [Accepted: 10/15/2021] [Indexed: 11/09/2022]
Abstract
This study aimed to investigate the cross-sectional association between serum sodium and blood pressure at baseline and, more importantly, investigate the prospective association between serum sodium and the risk of incident hypertension. We used data from 1 638 workers aged 18 to 71 years who participated in 2015-2016 survey of the Furukawa Nutrition and Health Study. During a maximum follow-up of 3 years, 229 participants developed hypertension. Multivariable linear regression models were used to evaluate the cross-sectional association. The Cox proportional hazards model was used to calculate the hazard ratio and 95% confidence interval of incident hypertension across quartiles of serum sodium (137-140, 141-142, 143, and 144-147 mmol/L). In the cross-sectional analysis, we did not observe a significant association between serum sodium and blood pressure at baseline. In the prospective analysis, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident hypertension were 1.03 (0.71-1.51), 1.35 (0.87-2.08), and 1.46 (0.97-2.20) for the upper three quartiles of the serum sodium levels compared with the lowest quartile (P for trend=0.02). When serum sodium was treated as a continuous variable, the multivariable-adjusted hazard ratio for hypertension was 1.10 (1.03-1.18). The association was slightly attenuated after additionally adjusting for baseline blood pressure, with a hazard ratio of 1.08 (1.00-1.16) for a 1 mmol/L increase in serum sodium. In conclusion, an elevated serum sodium level was associated with an increased risk of developing hypertension, suggesting that serum sodium could be a potential risk factor for hypertension.
Collapse
Affiliation(s)
- Huan Hu
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. .,Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan. .,Research Center for Prevention from Radiation Hazards of Workers, National Institute of Occupational Safety and Health, Kanagawa, Japan.
| | | | - Takako Miki
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Isamu Kabe
- KUBOTA Corporation Co., Ltd., Ibaraki, Japan
| | - Akiko Nanri
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Graham A Macgregor
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Feng J He
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
20
|
Sodium Intake as a Cardiovascular Risk Factor: A Narrative Review. Nutrients 2021; 13:nu13093177. [PMID: 34579054 PMCID: PMC8470268 DOI: 10.3390/nu13093177] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/05/2021] [Accepted: 09/10/2021] [Indexed: 01/11/2023] Open
Abstract
While sodium is essential for human homeostasis, current salt consumption far exceeds physiological needs. Strong evidence suggests a direct causal relationship between sodium intake and blood pressure (BP) and a modest reduction in salt consumption is associated with a meaningful reduction in BP in hypertensive as well as normotensive individuals. Moreover, while long-term randomized controlled trials are still lacking, it is reasonable to assume a direct relationship between sodium intake and cardiovascular outcomes. However, a consensus has yet to be reached on the effectiveness, safety and feasibility of sodium intake reduction on an individual level. Beyond indirect BP-mediated effects, detrimental consequences of high sodium intake are manifold and pathways involving vascular damage, oxidative stress, hormonal alterations, the immune system and the gut microbiome have been described. Globally, while individual response to salt intake is variable, sodium should be perceived as a cardiovascular risk factor when consumed in excess. Reduction of sodium intake on a population level thus presents a potential strategy to reduce the burden of cardiovascular disease worldwide. In this review, we provide an update on the consequences of salt intake on human health, focusing on BP and cardiovascular outcomes as well as underlying pathophysiological hypotheses.
Collapse
|
21
|
High Na + Salt Diet and Remodeling of Vascular Smooth Muscle and Endothelial Cells. Biomedicines 2021; 9:biomedicines9080883. [PMID: 34440087 PMCID: PMC8389691 DOI: 10.3390/biomedicines9080883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Our knowledge on essential hypertension is vast, and its treatment is well known. Not all hypertensives are salt-sensitive. The available evidence suggests that even normotensive individuals are at high cardiovascular risk and lower survival rate, as blood pressure eventually rises later in life with a high salt diet. In addition, little is known about high sodium (Na+) salt diet-sensitive hypertension. There is no doubt that direct and indirect Na+ transporters, such as the Na/Ca exchanger and the Na/H exchanger, and the Na/K pump could be implicated in the development of high salt-induced hypertension in humans. These mechanisms could be involved following the destruction of the cell membrane glycocalyx and changes in vascular endothelial and smooth muscle cells membranes’ permeability and osmolarity. Thus, it is vital to determine the membrane and intracellular mechanisms implicated in this type of hypertension and its treatment.
Collapse
|
22
|
Chang HW, Frey G, Liu H, Xing C, Steinman L, Boyle WJ, Short JM. Generating tumor-selective conditionally active biologic anti-CTLA4 antibodies via protein-associated chemical switches. Proc Natl Acad Sci U S A 2021; 118:e2020606118. [PMID: 33627407 PMCID: PMC7936328 DOI: 10.1073/pnas.2020606118] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Anticytotoxic T lymphocyte-associated protein 4 (CTLA4) antibodies have shown potent antitumor activity, but systemic immune activation leads to severe immune-related adverse events, limiting clinical usage. We developed novel, conditionally active biologic (CAB) anti-CTLA4 antibodies that are active only in the acidic tumor microenvironment. In healthy tissue, this binding is reversibly inhibited by a novel mechanism using physiological chemicals as protein-associated chemical switches (PaCS). No enzymes or potentially immunogenic covalent modifications to the antibody are required for activation in the tumor. The novel anti-CTLA4 antibodies show similar efficacy in animal models compared to an analog of a marketed anti-CTLA4 biologic, but have markedly reduced toxicity in nonhuman primates (in combination with an anti-PD1 checkpoint inhibitor), indicating a widened therapeutic index (TI). The PaCS encompass mechanisms that are applicable to a wide array of antibody formats (e.g., ADC, bispecifics) and antigens. Examples shown here include antibodies to EpCAM, Her2, Nectin4, CD73, and CD3. Existing antibodies can be engineered readily to be made sensitive to PaCS, and the inhibitory activity can be optimized for each antigen's varying expression level and tissue distribution. PaCS can modulate diverse physiological molecular interactions and are applicable to various pathologic conditions, enabling differential CAB antibody activities in normal versus disease microenvironments.
Collapse
MESH Headings
- 5'-Nucleotidase/antagonists & inhibitors
- 5'-Nucleotidase/genetics
- 5'-Nucleotidase/immunology
- Animals
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Humanized/chemistry
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Neoplasm/chemistry
- Antibodies, Neoplasm/pharmacology
- B7-H1 Antigen/antagonists & inhibitors
- B7-H1 Antigen/genetics
- B7-H1 Antigen/immunology
- Bicarbonates/chemistry
- CD3 Complex/antagonists & inhibitors
- CD3 Complex/genetics
- CD3 Complex/immunology
- CTLA-4 Antigen/antagonists & inhibitors
- CTLA-4 Antigen/genetics
- CTLA-4 Antigen/immunology
- Cell Adhesion Molecules/antagonists & inhibitors
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/immunology
- Colonic Neoplasms/genetics
- Colonic Neoplasms/immunology
- Colonic Neoplasms/pathology
- Colonic Neoplasms/therapy
- Epithelial Cell Adhesion Molecule/antagonists & inhibitors
- Epithelial Cell Adhesion Molecule/genetics
- Epithelial Cell Adhesion Molecule/immunology
- GPI-Linked Proteins/antagonists & inhibitors
- GPI-Linked Proteins/genetics
- GPI-Linked Proteins/immunology
- Gene Expression
- Humans
- Hydrogen Sulfide/chemistry
- Hydrogen-Ion Concentration
- Immunotherapy/methods
- Macaca fascicularis
- Mice
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Protein Engineering/methods
- Receptor, ErbB-2/antagonists & inhibitors
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/immunology
- T-Lymphocytes, Cytotoxic/drug effects
- T-Lymphocytes, Cytotoxic/immunology
- T-Lymphocytes, Cytotoxic/pathology
- Tumor Burden/drug effects
- Tumor Microenvironment/drug effects
- Xenograft Model Antitumor Assays
Collapse
Affiliation(s)
| | | | | | | | - Lawrence Steinman
- Stanford University School of Medicine, Stanford University, Stanford, CA 94305
| | | | | |
Collapse
|
23
|
Nevárez-López SC, Simental-Mendía LE, Guerrero-Romero F, Burciaga-Nava JA. Zinc deficiency is an independent risk factor for prehypertension in healthy subjects. INT J VITAM NUTR RES 2021; 91:25-30. [DOI: 10.1024/0300-9831/a000593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Abstract. Objective: To assess whether zinc deficiency is associated with prehypertension (preHTN) in apparently healthy subjects. Design: Apparently healthy women and men, aged 20 to 60 years were enrolled into a case-control study. Individuals with and without preHTN were allocated into the case and control groups, respectively. Hypertension, liver disease, renal disease, smoking, pregnancy, diabetes, malignancy, hypernatremia, hypomagnesemia, medical treatment, and use of supplements containing zinc were exclusion criteria. PreHTN was defined by systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) of 120–139 mmHg and/or of 80–89 mmHg, respectively, and the zinc deficiency by serum zinc levels < 74 μg/dL in men and < 70 μg/dL in women. Results: In total, 142 subjects (90 women and 52 men) were enrolled and allocated in the case (n = 71) and control (n = 71) groups. In the overall population, the frequency of zinc deficiency was 11.1%; individuals in the case group showed significant higher frequency of zinc deficiency as compared with the control group (16.9% vs 5.5%, p = 0.04). The logistic regression analysis showed a significant association between zinc deficiency and preHTN (OR = 4.61; 95% CI: 1.24–17.12, p = 0.02). Conclusion: Our results suggest that zinc deficiency is associated with the presence of preHTN in apparently healthy subjects.
Collapse
Affiliation(s)
- Sara C. Nevárez-López
- Departamento de Bioquímica, Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Durango, México
| | - Luis E. Simental-Mendía
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, México
| | - Fernando Guerrero-Romero
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, México
| | - Jorge A. Burciaga-Nava
- Departamento de Bioquímica, Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Durango, México
| |
Collapse
|
24
|
Safianu R, Plange-Rhule J. An Assessment of Usual Salt Intake among Older Normotensive Adults in Atonsu, a Suburb of Kumasi in the Ashanti Region of Ghana. Int J Hypertens 2020; 2020:7053654. [PMID: 33145108 PMCID: PMC7596423 DOI: 10.1155/2020/7053654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Globally, sodium intake has been found to be far above the normal level required by the body. Within countries, variations in salt intake exist between rural communities and urban communities. Experimental and epidemiological studies as well as studies involving clinical trials show the existence of adverse effect of salt consumption on the blood pressure of adults. The study evaluated salt intake among older normotensive adults in Atonsu, a suburb of Kumasi in the Ashanti region of Ghana. METHODS Participants were randomly selected from five churches which constituted cluster samples. A questionnaire was administered to participants for demographic information and dietary and lifestyle assessments. The study targeted 100 participants, twenty from each of the five churches. Eighty-two individuals gave their informed consent. Out of the 82 who gave their informed consent, 15 withdrew and 67 completed the course. The 67 participants comprised 36 (53.7%) men and 31 (46.3%) women. Systolic and diastolic blood pressure, BMI, urinary sodium, urinary potassium, serum creatinine, serum sodium, and serum potassium concentrations were also measured. RESULTS Participants' mean age was 52.3 ± 8.7 years. Participants had 24 hr urinary sodium excretion of 153.0 ± 26.9 mmol/day. All participants indicated that they consume foods high in salt even though none of them added salt to their diet at table. Mean 24 hr urinary potassium was 52.5 ± 12.9 mmol/day. Mean systolic blood pressure was 119.9 ± 10.8 mmHg and mean diastolic blood pressure was 72.5 ± 7.3 mmHg. Their mean BMI was 23.7 ± 3.5 kg/m2. CONCLUSION The participants who can be described as quite old and normotensive were high salt consumers, indicated by their dietary assessment and urinary sodium excretion, even though they had normal blood pressure.
Collapse
Affiliation(s)
- Rufai Safianu
- Department of Basic Medical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Jacob Plange-Rhule
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
25
|
He FJ, Tan M, Ma Y, MacGregor GA. Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75:632-647. [PMID: 32057379 DOI: 10.1016/j.jacc.2019.11.055] [Citation(s) in RCA: 252] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/04/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Abstract
There is strong evidence for a causal relationship between salt intake and blood pressure. Randomized trials demonstrate that salt reduction lowers blood pressure in both individuals who are hypertensive and those who are normotensive, additively to antihypertensive treatments. Methodologically robust studies with accurate salt intake assessment have shown that a lower salt intake is associated with a reduced risk of cardiovascular disease, all-cause mortality, and other conditions, such as kidney disease, stomach cancer, and osteoporosis. Multiple complex and interconnected physiological mechanisms are implicated, including fluid homeostasis, hormonal and inflammatory mechanisms, as well as more novel pathways such as the immune response and the gut microbiome. High salt intake is a top dietary risk factor. Salt reduction programs are cost-effective and should be implemented or accelerated in all countries. This review provides an update on the evidence relating salt to health, with a particular focus on blood pressure and cardiovascular disease, as well as the potential mechanisms.
Collapse
Affiliation(s)
- Feng J He
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
| | - Monique Tan
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Graham A MacGregor
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
26
|
Abstract
PURPOSE OF REVIEW The main goal of this article is to discuss the role of the epithelial sodium channel (ENaC) in extracellular fluid and blood pressure regulation. RECENT FINDINGS Besides its role in sodium handling in the kidney, recent studies have found that ENaC expressed in other cells including immune cells can influence blood pressure via extra-renal mechanisms. Dendritic cells (DCs) are activated and contribute to salt-sensitive hypertension in an ENaC-dependent manner. We discuss recent studies on how ENaC is regulated in both the kidney and other sites including the vascular smooth muscles, endothelial cells, and immune cells. We also discuss how this extra-renal ENaC can play a role in salt-sensitive hypertension and its promise as a novel therapeutic target. The role of ENaC in blood pressure regulation in the kidney has been well studied. Recent human gene sequencing efforts have identified thousands of variants among the genes encoding ENaC, and research efforts to determine if these variants and their expression in extra-renal tissue play a role in hypertension will advance our understanding of the pathogenesis of ENaC-mediated cardiovascular disease and lead to novel therapeutic targets.
Collapse
Affiliation(s)
- Ashley L Pitzer
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, 2215 Garland Avenue, P415C Medical Research Building IV, Nashville, TN, 37232, USA
| | - Justin P Van Beusecum
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, 2215 Garland Avenue, P415C Medical Research Building IV, Nashville, TN, 37232, USA
| | - Thomas R Kleyman
- Departments of Medicine, Cell Biology, Pharmacology, and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Annet Kirabo
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, 2215 Garland Avenue, P415C Medical Research Building IV, Nashville, TN, 37232, USA. .,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA.
| |
Collapse
|
27
|
Innovative tool for health promotion for at-risk Thai people with hypertension. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01028-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
28
|
Del Vecchio JJ, Hosick PA, Matthews EL. Oral saline consumption and pressor responses to acute physical stress. Physiol Int 2020; 107:306-318. [PMID: 32667902 DOI: 10.1556/2060.2020.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/15/2020] [Indexed: 11/19/2022]
Abstract
Sodium induced volume loading may alter pressor responses to physical stress, an early symptom of cardiovascular disease. PURPOSE Study 1: Determine the time point where total blood volume and serum sodium were elevated following saline consumption. Study 2: Examine the BP response to isometric handgrip (HG) and the cold pressor test (CPT) following saline consumption. METHODS Study 1: Eight participants drank 423 mL of normal saline (sodium 154 mmol/L) and had blood draws every 30 min for 3 h. Study 2: Sixteen participants underwent two randomized data collection visits; a control and experimental visit 90 min following saline consumption. Participants underwent 2 min of isometric HG, post exercise ischemia (PEI), and CPT. RESULTS Study 1: Total blood volume (3.8 ± 3.0 Δ%) and serum sodium (3.5 ± 3.6 Δ%) were elevated (P < 0.05) by the 90 min time point. Study 2: There were no differences in mean arterial pressure (MAP) during HG (EXP: 17.4 ± 8.2 ΔmmHg; CON: 19.1 ± 6.0 ΔmmHg), PEI (EXP: 16.9 ± 11.7 ΔmmHg; CON: 16.9 ± 7.8 ΔmmHg), or the CPT (EXP: 20.3 ± 10.8 ΔmmHg; CON: 20.9 ± 11.7 ΔmmHg) between conditions (P > 0.05). MAP recovery from the CPT was slower following saline consumption (1 min recovery: EXP; 15.7 ± 7.9 ΔmmHg, CON; 12.3 ± 8.9 ΔmmHg, P < 0.05). CONCLUSION Data showed no difference in cardiovascular responses during HG or the CPT between conditions. BP recovery was delayed by saline consumption following the CPT.
Collapse
Affiliation(s)
- J J Del Vecchio
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ, USA
| | - P A Hosick
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ, USA
| | - E L Matthews
- Department of Exercise Science and Physical Education, Montclair State University, Montclair, NJ, USA
| |
Collapse
|
29
|
The physiological and molecular mechanisms to maintain water and salt homeostasis in response to high salt intake in Mongolian gerbils (Meriones unguiculatus). J Comp Physiol B 2020; 190:641-654. [PMID: 32556536 DOI: 10.1007/s00360-020-01287-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 05/29/2020] [Accepted: 06/07/2020] [Indexed: 12/19/2022]
Abstract
Desert rodents are faced with many challenges such as high dietary salt in their natural habitats and they have evolved abilities to conserve water and tolerate salt. However, the physiological and molecular mechanisms involved in water and salt balances in desert rodents are unknown. We hypothesized that desert rodents regulated water and salt balances by altering the expression of AQP2 and α-ENaC in the kidney. Mongolian gerbils (Meriones unguiculatus), a desert species, were acclimated to drinking water with different salt contents: (0, control; 4% NaCl, moderate salt, MS; 8% NaCl, high salt, HS) for 4 weeks. The gerbils drinking salty water had lower body mass, food intake, water intake, metabolic water production and urine volume. The HS gerbils increased the expression of arginine vasopressin (AVP) in the hypothalamus, and also enhanced the expression of AQP2 and cAMP/PKA/CREB signaling pathway in the kidney. In addition, these gerbils reduced serum aldosterone levels and α-ENaC expression in the kidney. Creatinine clearance was lower in the HS group than that in the control group, but serum and urine creatinine levels did not change. These data indicate that desert rodents rely on AVP-dependent upregulation of AQP2 and aldosterone-dependent downregulation of α-ENaC in the kidney to promote water reabsorption and sodium excretion under high salt intake.
Collapse
|
30
|
Underhydration Is Associated with Obesity, Chronic Diseases, and Death Within 3 to 6 Years in the U.S. Population Aged 51-70 Years. Nutrients 2020; 12:nu12040905. [PMID: 32224908 PMCID: PMC7230456 DOI: 10.3390/nu12040905] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/14/2022] Open
Abstract
Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) indicate that over 65% of adults aged 51–70 years in the U.S. do not meet hydration criteria. They have hyponatremia (serum sodium < 135 mmol/L) and/or underhydration (serum sodium >145 mmol/L, spot urine volume <50 mL, and/or spot urine osmolality ≥500 mmol/kg). To explore potential public health implications of not meeting hydration criteria, data from the NHANES 2009–2012 and National Center for Health Statistics Linked Mortality Files for fasting adults aged 51–70 years (sample n = 1200) were used to determine if hyponatremia and/or underhydration were cross-sectionally associated with chronic health conditions and/or longitudinally associated with chronic disease mortality. Underhydration accounted for 97% of the population group not meeting hydration criteria. In weighted multivariable adjusted Poisson models, underhydration was significantly associated with increased prevalence of obesity, high waist circumference, insulin resistance, diabetes, low HDL, hypertension, and metabolic syndrome. Over 3–6 years of follow-up, 33 chronic disease deaths occurred in the sample, representing an estimated 1,084,144 deaths in the U.S. Alongside chronic health conditions, underhydration was a risk factor for an estimated 863,305 deaths. Independent of the chronic health conditions evaluated, underhydration was a risk factor for 128,107 deaths. In weighted multivariable Cox models, underhydration was associated with 4.21 times greater chronic disease mortality (95% CI: 1.29–13.78, p = 0.019). Zero chronic disease deaths were observed for people who met the hydration criteria and did not already have a chronic condition in 2009–2012. Further work should consider effects of underhydration on population health.
Collapse
|
31
|
Jabri L, Rosenthal DM, Benton L, Lakhanpaul M. Complementary feeding practices and nutrient intakes of children aged 6-24 months from Bangladeshi background living in Tower Hamlets, East London: a feasibility study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:4. [PMID: 32111257 PMCID: PMC7048146 DOI: 10.1186/s41043-020-0213-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 02/05/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study was to assess dietary intakes and complementary feeding practices of children aged 6-24 months who are from Bangladeshi ancestry and living in Tower Hamlets, London, and determine the feasibility of a larger, population-representative study. METHODS Questionnaires for demographic variables and feeding practices, and 24-h dietary recalls were administered to 25 mothers to determine whether it would be feasible to conduct a similar study on a representative sample size of the same population. Data from both tools were used to determine adequacy of complementary feeding practices through the WHO indicators and an infant and child feeding index score as well as overall macronutrient and micronutrient intake. RESULTS Four children had varying suboptimal complementary feeding practices: two children failed to achieve the minimum dietary diversity, one child was being fed cow's milk before the age of 1 year, and one scored 'poor' on the infant and child feeding index. Most notably, the mean protein intake (39.7 g/day, SD 18.2) was higher than RNIs for all age groups (P = 0.001). Vitamin D intake was below recommendations (P = 0.006) for the 12-24-month age group. For the 10-12-month age group, zinc intake fell below recommendations (P = 0.028). For the 6-9-month combined age group, iron and zinc intakes were below recommendations (P = 0.021 and P = 0.002, respectively). CONCLUSIONS Given the feasibility of this study, the results obtained require a large-scale study to be conducted to confirm findings. Our initial results indicated that children from Bangladeshi heritage may not be meeting nutritional requirements; thus, a future intervention tailored to the needs of the Bangladeshi population may be required to improve aspects of complementary feeding practices and nutrient intakes of those children.
Collapse
Affiliation(s)
- Laura Jabri
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
| | - Diana Margot Rosenthal
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
- UCL Collaborative Centre for Inclusion Health, Department of Epidemiology and Public Health, London, WC1E 7HB UK
| | - Lorna Benton
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
| | - Monica Lakhanpaul
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
- UCL Collaborative Centre for Inclusion Health, Department of Epidemiology and Public Health, London, WC1E 7HB UK
| |
Collapse
|
32
|
Souza LAC, Trebak F, Kumar V, Satou R, Kehoe PG, Yang W, Wharton W, Feng Earley Y. Elevated cerebrospinal fluid sodium in hypertensive human subjects with a family history of Alzheimer's disease. Physiol Genomics 2020; 52:133-142. [PMID: 31961762 DOI: 10.1152/physiolgenomics.00093.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
High salt (sodium) intake leads to the development of hypertension despite the fact that plasma sodium concentration ([Na+]) is usually normal in hypertensive human patients. Increased cerebrospinal fluid (CSF) sodium contributes to elevated sympathetic activity and high blood pressure (BP) in rodent models of hypertension. However, whether there is an increased accumulation of sodium in the CSF of humans with chronic hypertension is not well defined. Here, we investigated CSF [Na+] from hypertensive and normotensive human subjects with family histories of Alzheimer's disease in samples collected in a clinical trial, as spinal tap is not a routine clinical procedure for hypertensive patients. The [Na+] and osmolality in plasma and CSF were measured by flame photometry. Daytime ambulatory BP was monitored while individuals were awake. Participants were deidentified and data were analyzed in conjunction with a retrospective analysis of patient history and diagnosis. We found that CSF [Na+] was significantly higher in participants with high BP compared with normotensive participants; there was no difference in plasma [Na+], or plasma and CSF osmolality between groups. Subsequent multiple linear regression analyses controlling for age, sex, race, and body mass index revealed a significant positive correlation between CSF [Na+] and BP but showed no correlation between plasma [Na+] and BP. In sum, CSF [Na+] was higher in chronic hypertensive individuals and may play a key role in the pathogenesis of human hypertension. Collectively, our findings provide evidence for the clinical significance of CSF [Na+] in chronic hypertension in humans.
Collapse
Affiliation(s)
- Lucas A C Souza
- Departments of Pharmacology and Physiology & Cell Biology, University of Nevada, Reno, School of Medicine, Reno, Nevada.,Center for Molecular and Cellular Signaling in the Cardiovascular System, University of Nevada, Reno, Reno, Nevada
| | - Fatima Trebak
- Departments of Pharmacology and Physiology & Cell Biology, University of Nevada, Reno, School of Medicine, Reno, Nevada.,Center for Molecular and Cellular Signaling in the Cardiovascular System, University of Nevada, Reno, Reno, Nevada
| | - Veena Kumar
- Department of Neurology, Emory University School of Nursing, Atlanta, Georgia
| | - Ryousuke Satou
- Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Patrick G Kehoe
- Institute of Clinical Neurosciences, University of Bristol, Bristol, United Kingdom
| | - Wei Yang
- University of Nevada, Reno, School of Community Health Sciences, Reno, Nevada
| | - Whitney Wharton
- Department of Neurology, Emory University School of Nursing, Atlanta, Georgia
| | - Yumei Feng Earley
- Departments of Pharmacology and Physiology & Cell Biology, University of Nevada, Reno, School of Medicine, Reno, Nevada.,Center for Molecular and Cellular Signaling in the Cardiovascular System, University of Nevada, Reno, Reno, Nevada
| |
Collapse
|
33
|
Agbaraolorunpo FM, Sofola OA, Anigbogu CN, Azinge EC. Angiotensin receptor blockade with Losartan attenuates pressor response to handgrip contraction and enhances natriuresis in salt loaded hypertensive subjects: a quasi-experimental study among Nigerian adults. Pan Afr Med J 2019; 34:188. [PMID: 32180862 PMCID: PMC7060958 DOI: 10.11604/pamj.2019.34.188.18317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/18/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Sympathetic and Renin-Angiotensin-Aldosterone systems play crucial roles in blood pressure response to increased salt intake. This study investigated the effects of angiotensin receptor blocker (ARB) and sympathetic excitation on the responses of blood pressure (BP) and peripheral vascular resistance (PVR) in salt loaded normotensive (NT) and hypertensive (HT) Nigerian subjects. METHODS 16 NT and 14 HT participants, that were age-matched [39.9 ± 1.3 vs 44.1±2.1yrs (P= 0.10)], underwent 5 days each of oral administration of 200mmol NaCl, and 200mmol NaCl + 50mg Losartan, preceded by a baseline control condition. BP and PVR responses to 30% Maximum Voluntary Contraction (MVC) of handgrip (HG) for one minute were determined at baseline, after salt load and after salt + Losartan. Data were presented as Mean ± SEM, and analyzed with two-way ANOVA and paired t-test, with P<0.05 accepted as significant. RESULTS BP and PVR were significantly increased by HG at baseline, after salt load and after salt + Losartan in NT and HT. Salt load augmented the HG-induced SBP (P=0.04) and MABP responses (P=0.02) in HT. While Losartan attenuated the HG- induced Systolic Blood Pressure (SBP) SBP response (P=0.007) and DBP response (P=0.003) in HT and NT respectively after salt + Losartan. HG-induced PVR response was significantly accentuated after salt load in HT (P=0.005), but it was not significant in NT (P=0.38). CONCLUSION The implication of our finding is that angiotensin II receptor blockade possibly attenuates salt-induced sympathetic nerve excitation in black hypertensive patients.
Collapse
Affiliation(s)
| | | | | | - Elaine Chinyelu Azinge
- Department of Clinical Pathology, College of Medicine, University of Lagos, Lagos, Nigeria
| |
Collapse
|
34
|
Sokolowski CM, Higgins S, Vishwanathan M, Evans EM. The relationship between animal and plant protein intake and overall diet quality in young adults. Clin Nutr 2019; 39:2609-2616. [PMID: 31839431 DOI: 10.1016/j.clnu.2019.11.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 11/10/2019] [Accepted: 11/21/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS Overall diet quality is a key predictor of disease risk and mortality. Diets higher in animal protein have been associated with increased disease risk and all-cause mortality. However, the source of protein consumed will inevitably influence the intake of other macronutrients and micronutrients which can also play a role in the onset of disease. The aim of the present study was to assess the relationship between animal and plant protein intake and overall diet quality in young adult females and males. METHODS Dietary intake was assessed via 3-day food log (n = 150; 53% females) and data were analyzed using the Nutrition Data Systems for Research (NDSR). RESULTS Females and males consuming <70% of their protein from animal sources had higher scores on a modified Healthy Eating Index (HEI) compared those consuming >70% of their protein from animal sources. Males scored lower than females on the modified HEI regardless of protein source intake variation. CONCLUSIONS Our findings suggest that overall diet quality differs with varying protein source consumption and eating <70% of protein from animal sources might lead to a better score on the HEI. Future research investigating protein source and disease risk should examine overall dietary quality as a potential effect modifier.
Collapse
Affiliation(s)
- Chester M Sokolowski
- Department of Kinesiology, University of Georgia, Athens, GA, USA; Department of Food, Nutrition, and Exercise Sciences, Florida State University, Tallahassee, FL, USA.
| | - Simon Higgins
- Department of Kinesiology, University of Georgia, Athens, GA, USA; Department of Exercise Science, Elon University, Elon, NC, USA
| | | | - Ellen M Evans
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| |
Collapse
|
35
|
Eren OC, Ortiz A, Afsar B, Covic A, Kuwabara M, Lanaspa MA, Johnson RJ, Kanbay M. Multilayered Interplay Between Fructose and Salt in Development of Hypertension. Hypertension 2019; 73:265-272. [PMID: 30595116 DOI: 10.1161/hypertensionaha.118.12150] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ozgur C Eren
- Department of Medicine, Koç University School of Medicine, Istanbul, Turkey (O.C.E., M. Kanbay)
| | - Alberto Ortiz
- Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Spain (A.O.)
| | - Baris Afsar
- Division of Nephrology, Department of Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey (B.A.)
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania (A.C.)
| | - Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital, Tokyo, Japan (M. Kuwabara)
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.A.L., R.J.J.)
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.A.L., R.J.J.)
| | - Mehmet Kanbay
- From the Division of Nephrology, Koç University School of Medicine, Istanbul, Turkey (M. Kanbay).,Department of Medicine, Koç University School of Medicine, Istanbul, Turkey (O.C.E., M. Kanbay)
| |
Collapse
|
36
|
Naser AM, Rahman M, Unicomb L, Doza S, Anand S, Chang HH, Luby SP, Clasen TF, Narayan KV. Comparison of Urinary Sodium and Blood Pressure Relationship From the Spot Versus 24-Hour Urine Samples. J Am Heart Assoc 2019; 8:e013287. [PMID: 31615314 PMCID: PMC6898815 DOI: 10.1161/jaha.119.013287] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/09/2019] [Indexed: 01/10/2023]
Abstract
Background We compared the relationship between sodium (Na) intake and blood pressure when Na intake was estimated from first- and second-morning spot urine samples using the INTERSALT (International Study on Salt and Blood Pressure) formula, versus directly measured 24-hour samples. Methods and Results We collected 24-hour urine and first- and second-morning voids of 383 participants in coastal Bangladesh for 2 visits. We measured participants' blood pressure using an Omron® HEM-907 monitor. To assess the shape of the relationship between urinary Na and blood pressure, we created restricted cubic spline plots adjusted for age, sex, body mass index, smoking and alcohol consumption, physical activities, religion, sleep hours, and household wealth. To assess multicollinearity, we reported variance inflation factors, tolerances, and Leamer's and Klein's statistics following linear regression models. The mean daily urinary Na was 122 (SD 26) mmol/d for the first; 122 (SD 27) mmol/d for the second; and 134 (SD 70) mmol/d for the 24-hour samples. The restricted cubic spline plots illustrated no association between first-morning urinary Na and systolic blood pressure until the 90th percentile distribution followed by a downward relationship; a nonlinear inverse-V-shaped relationship between second-morning urinary Na and systolic blood pressure; and a monotonic upward relationship between 24-hour urinary Na and systolic blood pressure. We found no evidence of multicollinearity for the 24-hour urinary Na model. Conclusions The urinary Na and systolic blood pressure relationship varied for 3 urinary Na measurements. Twenty-four-hour urinary Na captured more variability of Na intake compared with spot urine samples, and its regression models were not affected by multicollinearity.
Collapse
Affiliation(s)
- Abu Mohd Naser
- Department of Environmental Health SciencesRollins School of Public HealthEmory UniversityAtlantaGA
- Emory Global Diabetes Research CenterHubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGA
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b)DhakaBangladesh
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b)DhakaBangladesh
| | - Solaiman Doza
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b)DhakaBangladesh
| | - Shuchi Anand
- Division of NephrologySchool of MedicineStanford UniversityStanfordCA
| | - Howard H. Chang
- Department of Biostatistics and BioinformaticsRollins School of Public HealthEmory UniversityAtlantaGA
| | - Stephen P. Luby
- Woods Institute for the EnvironmentStanford UniversityStanfordCA
| | - Thomas F. Clasen
- Department of Environmental Health SciencesRollins School of Public HealthEmory UniversityAtlantaGA
| | - K.M. Venkat Narayan
- Emory Global Diabetes Research CenterHubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGA
| |
Collapse
|
37
|
Turck D, Castenmiller J, de Henauw S, Hirsch-Ernst KI, Kearney J, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Aggett P, Fairweather-Tait S, Martin A, Przyrembel H, Ciccolallo L, de Sesmaisons-Lecarré A, Valtueña Martinez S, Martino L, Naska A. Dietary reference values for sodium. EFSA J 2019; 17:e05778. [PMID: 32626425 PMCID: PMC7009309 DOI: 10.2903/j.efsa.2019.5778] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) derived dietary reference values (DRVs) for sodium. Evidence from balance studies on sodium and on the relationship between sodium intake and health outcomes, in particular cardiovascular disease (CVD)-related endpoints and bone health, was reviewed. The data were not sufficient to enable an average requirement (AR) or population reference intake (PRI) to be derived. However, by integrating the available evidence and associated uncertainties, the Panel considers that a sodium intake of 2.0 g/day represents a level of sodium for which there is sufficient confidence in a reduced risk of CVD in the general adult population. In addition, a sodium intake of 2.0 g/day is likely to allow most of the general adult population to maintain sodium balance. Therefore, the Panel considers that 2.0 g sodium/day is a safe and adequate intake for the general EU population of adults. The same value applies to pregnant and lactating women. Sodium intakes that are considered safe and adequate for children are extrapolated from the value for adults, adjusting for their respective energy requirement and including a growth factor, and are as follows: 1.1 g/day for children aged 1-3 years, 1.3 g/day for children aged 4-6 years, 1.7 g/day for children aged 7-10 years and 2.0 g/day for children aged 11-17 years, respectively. For infants aged 7-11 months, an Adequate Intake (AI) of 0.2 g/day is proposed based on upwards extrapolation of the estimated sodium intake in exclusively breast-fed infants aged 0-6 months.
Collapse
|
38
|
Health Consequences of Lake Urmia in Crisis in the Disaster Area: A Pilot Study. Disaster Med Public Health Prep 2019; 14:442-448. [PMID: 31452493 DOI: 10.1017/dmp.2019.61] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study investigated the health effects of Lake Urmia's drought on adjacent urban and rural areas and people. METHODS The data for sociodemographic status, physical activity, dietary pattern, smoking, and angina of the subjects living in areas adjacent to and far from Lake Urmia were collected through validated questionnaires. Physical examinations, including blood pressure, anthropometrics, and biochemical measurements, were performed. RESULTS There were no significant differences between 2 areas in the case of age, sex, educational, and physical activity and smoking status (P > 0.05). The mean systolic and diastolic blood pressures and the prevalence of hypertension, prehypertension, and anemia in cases living in the adjacent areas were significantly higher than those in the control group (P < 0.05). No significant differences were observed between 2 districts in the prevalence of hyperlipidemia, overweight/obesity, asthma, angina, infraction, diabetes, and vitamin D insufficiency/deficiency. CONCLUSIONS Our data showed that Lake Urmia's drought has serious effects on hypertension and anemia. More longitudinal and well-designed studies are needed to confirm these results.
Collapse
|
39
|
Elemental distribution in the aortic arch using LEXRF: Side effects of angiotensin receptor blockers as antihypertensive treatment. Microchem J 2019. [DOI: 10.1016/j.microc.2019.05.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
40
|
Nowak KL, Chonchol M, Jovanovich A, You Z, Bates J, Foy C, Glasser S, Killeen AA, Kostis J, Rodriguez CJ, Segal M, Simmons DL, Taylor A, Lovato LC, Ambrosius WT, Supiano MA. Serum Sodium and Pulse Pressure in SPRINT. Am J Hypertens 2019; 32:649-656. [PMID: 30977767 DOI: 10.1093/ajh/hpz055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 03/29/2019] [Accepted: 04/09/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure. Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS Multivariable linear regression was used to examine the association between baseline serum sodium level and (i) pulse pressure (PP; n = 8,813; a surrogate measure of arterial stiffness) and (ii) carotid-femoral pulse wave velocity (CFPWV; n = 591 in an ancillary study to SPRINT). RESULTS Baseline mean ± SD age was 68 ± 9 years and serum sodium level was 140 ± 2 mmol/L. In the PP analysis, higher serum sodium was associated with increased baseline PP in the fully adjusted model (tertile 3 [≥141 mmol] vs. tertile 2 [139-140 mmol]; β = 0.87, 95% CI = 0.32 to 1.43). Results were similar in those with and without chronic kidney disease. In the ancillary study, higher baseline serum sodium was not associated with increased baseline CFPWV in the fully adjusted model (β = 0.35, 95% CI = -0.14 to 0.84). CONCLUSIONS Among adults at high risk for cardiovascular events but free from diabetes, higher serum sodium was independently associated with baseline arterial stiffness in SPRINT, as measured by PP, but not by CFPWV. These results suggest that high serum sodium may be a marker of risk for increased PP, a surrogate index of arterial stiffness.
Collapse
Affiliation(s)
- Kristen L Nowak
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Anna Jovanovich
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Zhiying You
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jeffrey Bates
- Division of General Internal Medicine, Houston Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA
| | - Capri Foy
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephen Glasser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anthony A Killeen
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - John Kostis
- Division of Cardiology, The Cardiovascular Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Carlos J Rodriguez
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark Segal
- Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, Florida, USA
| | - Debra L Simmons
- Division of Endocrinology, University of Utah and VA Salt Lake City, Salt Lake City, Utah, USA
| | - Addison Taylor
- Division of General Internal Medicine, Houston Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA
| | - Laura C Lovato
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Walter T Ambrosius
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark A Supiano
- Division of Geriatrics, University of Utah, Salt Lake City, Utah, USA
- VA Salt Lake City Health Care System, Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah, USA
| | | |
Collapse
|
41
|
Komnenov D, Levanovich PE, Rossi NF. Hypertension Associated with Fructose and High Salt: Renal and Sympathetic Mechanisms. Nutrients 2019; 11:nu11030569. [PMID: 30866441 PMCID: PMC6472002 DOI: 10.3390/nu11030569] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/26/2019] [Accepted: 03/04/2019] [Indexed: 02/06/2023] Open
Abstract
Hypertension is a leading cause of cardiovascular and chronic renal disease. Despite multiple important strides that have been made in our understanding of the etiology of hypertension, the mechanisms remain complex due to multiple factors, including the environment, heredity and diet. This review focuses on dietary contributions, providing evidence for the involvement of elevated fructose and salt consumption that parallels the increased incidence of hypertension worldwide. High fructose loads potentiate salt reabsorption by the kidney, leading to elevation in blood pressure. Several transporters, such as NHE3 and PAT1 are modulated in this milieu and play a crucial role in salt-sensitivity. High fructose ingestion also modulates the renin-angiotensin-aldosterone system. Recent attention has been shifted towards the contribution of the sympathetic nervous system, as clinical trials demonstrated significant reductions in blood pressure following renal sympathetic nerve ablation. New preclinical data demonstrates the activation of the renal sympathetic nerves in fructose-induced salt-sensitive hypertension, and reductions of blood pressure after renal nerve ablation. This review further demonstrates the interplay between sodium handling by the kidney, the renin-angiotensin-aldosterone system, and activation of the renal sympathetic nerves as important mechanisms in fructose and salt-induced hypertension.
Collapse
Affiliation(s)
- Dragana Komnenov
- Department of Physiology, Wayne State University, 4160 John R Street #908, Detroit, MI 48201, USA.
- Department of Internal Medicine, Wayne State University, 4160 John R Street #908, Detroit, MI 48201, USA.
| | - Peter E Levanovich
- Department of Physiology, Wayne State University, 4160 John R Street #908, Detroit, MI 48201, USA.
| | - Noreen F Rossi
- Department of Physiology, Wayne State University, 4160 John R Street #908, Detroit, MI 48201, USA.
- Department of Internal Medicine, Wayne State University, 4160 John R Street #908, Detroit, MI 48201, USA.
- John D. Dingell VA Medical Center, 4646 John R Street, Detroit, MI 48201, USA.
| |
Collapse
|
42
|
Herman BA, Ferguson KM, Fernandez JVB, Kauffman S, Spicher JT, King RJ, Halterman JA. NFAT5 is differentially expressed in Sprague-Dawley rat tissues in response to high salt and high fructose diets. Genet Mol Biol 2019; 42:452-464. [PMID: 30816906 PMCID: PMC6726159 DOI: 10.1590/1678-4685-gmb-2018-0120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/24/2018] [Indexed: 12/31/2022] Open
Abstract
Current diets contain an increasing amount of salt and high fructose corn syrup,
but it remains unclear as to how dietary salt and fructose affect organ function
at the molecular level. This study aimed to test the hypothesis that consumption
of high salt and fructose diets would increase tissue-specific expression of two
critical osmotically-regulated genes, nuclear factor of activated T-cells 5
(NFAT5) and aldose reductase (AR). Fifty
Sprague-Dawley rats were placed on a control, 4% NaCl, 8% NaCl, or 64% fructose
diet for eight weeks. Fourteen different tissue samples were harvested and
snap-frozen, followed by RNA purification, cDNA synthesis, and
NFAT5 and AR gene expression
quantification by real-time PCR.Our findings demonstrate that
NFAT5 and AR expression are up-regulated
in the kidney medulla, liver, brain, and adipose tissue following consumption of
a high salt diet. NFAT5 expression is also up-regulated in the
kidney cortex following consumption of a 64% fructose diet. These findings
highlight the kidney medulla, liver, brain, and adipose tissue as being
“salt-responsive” tissues and reveal that a high fructose diet can lead to
enhanced NFAT5 expression in the kidney cortex. Further
characterization of signaling mechanisms involved could help elucidate how these
diets affect organ function long term.
Collapse
Affiliation(s)
- Braden A Herman
- Department of Biology, Eastern Mennonite University, Harrisonburg, VA, USA
| | - Kaylee M Ferguson
- Department of Biology, Eastern Mennonite University, Harrisonburg, VA, USA
| | - Jared V B Fernandez
- Master's in Biomedicine Program, Eastern Mennonite University, Harrisonburg, VA, USA
| | - Samantha Kauffman
- Department of Biology, Eastern Mennonite University, Harrisonburg, VA, USA
| | - Jason T Spicher
- Department of Biology, Eastern Mennonite University, Harrisonburg, VA, USA
| | - Rachel J King
- Department of Biology, Eastern Mennonite University, Harrisonburg, VA, USA
| | - Julia A Halterman
- Department of Biology, Eastern Mennonite University, Harrisonburg, VA, USA.,Master's in Biomedicine Program, Eastern Mennonite University, Harrisonburg, VA, USA
| |
Collapse
|
43
|
Matsuo T, Miyata Y, Sakai H. Effect of salt intake reduction on nocturia in patients with excessive salt intake. Neurourol Urodyn 2019; 38:927-933. [PMID: 30706965 DOI: 10.1002/nau.23929] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/04/2018] [Accepted: 12/26/2018] [Indexed: 12/29/2022]
Abstract
AIMS To assess the efficacy of salt reduction for improving nocturia in patients with high salt intake. METHODS Changes in lower urinary symptoms and frequency volume chart by salt intake (men: 8 g/day; women: ≥7 g/day) were analyzed in this prospective study. Patients were instructed to use a brochure for salt intake restriction via interview once every four weeks. The daily salt intake was estimated by using spot urine samples. RESULTS Two-hundred twenty-three (69.5%) patients were successful in reducing their daily salt intake (S group), whereas 98 (30.5%) patients failed to reduce their salt intake (F group). In the S group, nocturia improved from 2.3 ± 0.9 to 1.4 ± 1.0, and nocturnal polyuria index (NPi) improved from 30.2 ± 7.5 to 27.7 ± 7.3% (P < 0.001). In the Core Lower Urinary Tract Symptom Score (CLSS) of the S group, Q3 (urgency) improved from 1.0 ± 1.0 to 0.9 ± 1.0 (P = 0.001); Q1 (diurnal frequency) (P < 0.001), and Q2 (nocturia) also improved (P < 0.001). Moreover, the quality of life parameter improved significantly (P < 0.001). The patients in the F group did not have improvements in any symptom during the study period. CONCLUSIONS Patients with nocturia who also have high salt intake should be advised to reduce their salt intake, as a lifestyle modification. Our results support the importance of randomized clinical trials with larger populations and the appropriate inclusion/exclusion criteria to conclude the clinical usefulness of salt reduction in this patient cohort.
Collapse
Affiliation(s)
- Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yasuyoshi Miyata
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideki Sakai
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
44
|
Karava V, Benzouid C, Kwon T, Macher MA, Deschênes G, Hogan J. Interdialytic weight gain and vasculopathy in children on hemodialysis: a single center study. Pediatr Nephrol 2018; 33:2329-2336. [PMID: 30178237 DOI: 10.1007/s00467-018-4026-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/04/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Increased interdialytic weight gain (IDWG) has been associated with poor outcomes in adults, but its impact on hemodialysis vasculopathy in children is unknown. METHODS Nineteen patients (age 9 to 19 years old) with a median hemodialysis duration of 10.4 months were enrolled. Cardiovascular evaluation included left ventricular mass index (LVMI), pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) measurements. PWV and cIMT were expressed as z-scores based on reference values in healthy children. Blood pressure (BP) evaluation consisted in a 24-h ambulatory BP monitoring. Mean IDGW and residual urine output during the 6 months prior to cardiovascular examination were calculated. RESULTS Increased cIMT, LVMI, and PWV was observed in 11 (57.9%), 7 (36.8%), and 5 (26.3%) patients respectively, while BP was normal in all patients. Median IDWG was 3.5% (1.8-6.7). Residual urine output and BP status did not significantly differ between patients with IDWG ≥ or < 4%. After linear regression, IDWG was correlated to cIMT z-score (r2 = 0.485, p = 0.001), but not to PWV z-score (r2 = 0.04, p = 0.415) and LVMI (r2 = 0.092, p = 0.206). After univariate logistic regression, IDWG ≥ 4% was significantly associated to increased cIMT (above 1.65 SDS) (odds ratio 12.25, 95% confidence interval 1.08-138.988). The trend toward an increased cIMT with IDWG ≥ 4% was observed in both patients with short and long dialysis vintage. CONCLUSIONS High IDWG is associated with increased cIMT in hemodialyzed children independently of BP control and dialysis vintage. This observation reinforces the importance of interventions to avoid IDWG in hemodialyzed children.
Collapse
Affiliation(s)
- Vasiliki Karava
- Pediatric Nephrology Department, Robert Debré Hospital, APHP, Paris, France.
| | - Cherine Benzouid
- Pediatric Cardiology Department, Robert Debré Hospital, APHP, Paris, France
| | - Theresa Kwon
- Pediatric Nephrology Department, Robert Debré Hospital, APHP, Paris, France
| | - Marie-Alice Macher
- Pediatric Nephrology Department, Robert Debré Hospital, APHP, Paris, France
| | - Georges Deschênes
- Pediatric Nephrology Department, Robert Debré Hospital, APHP, Paris, France
| | - Julien Hogan
- Pediatric Nephrology Department, Robert Debré Hospital, APHP, Paris, France
| |
Collapse
|
45
|
Nomura K, Hiyama TY, Sakuta H, Matsuda T, Lin CH, Kobayashi K, Kobayashi K, Kuwaki T, Takahashi K, Matsui S, Noda M. [Na +] Increases in Body Fluids Sensed by Central Na x Induce Sympathetically Mediated Blood Pressure Elevations via H +-Dependent Activation of ASIC1a. Neuron 2018; 101:60-75.e6. [PMID: 30503172 DOI: 10.1016/j.neuron.2018.11.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/08/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023]
Abstract
Increases in sodium concentrations ([Na+]) in body fluids elevate blood pressure (BP) by enhancing sympathetic nerve activity (SNA). However, the mechanisms by which information on increased [Na+] is translated to SNA have not yet been elucidated. We herein reveal that sympathetic activation leading to BP increases is not induced by mandatory high salt intakes or the intraperitoneal/intracerebroventricular infusions of hypertonic NaCl solutions in Nax-knockout mice in contrast to wild-type mice. We identify Nax channels expressed in specific glial cells in the organum vasculosum lamina terminalis (OVLT) as the sensors detecting increases in [Na+] in body fluids and show that OVLT neurons projecting to the paraventricular nucleus (PVN) are activated via acid-sensing ion channel 1a (ASIC1a) by H+ ions exported from Nax-positive glial cells. The present results provide an insight into the neurogenic mechanisms responsible for salt-induced BP elevations.
Collapse
Affiliation(s)
- Kengo Nomura
- Division of Molecular Neurobiology, National Institute for Basic Biology, Okazaki, Aichi 444-8787, Japan
| | - Takeshi Y Hiyama
- Division of Molecular Neurobiology, National Institute for Basic Biology, Okazaki, Aichi 444-8787, Japan; School of Life Science, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Aichi 444-8787, Japan
| | - Hiraki Sakuta
- Division of Molecular Neurobiology, National Institute for Basic Biology, Okazaki, Aichi 444-8787, Japan; School of Life Science, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Aichi 444-8787, Japan
| | - Takashi Matsuda
- Division of Molecular Neurobiology, National Institute for Basic Biology, Okazaki, Aichi 444-8787, Japan
| | - Chia-Hao Lin
- Division of Molecular Neurobiology, National Institute for Basic Biology, Okazaki, Aichi 444-8787, Japan
| | - Kenta Kobayashi
- Section of Viral Vector Development, National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan
| | - Kazuto Kobayashi
- Department of Molecular Genetics, Institute of Biomedical Sciences, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Tomoyuki Kuwaki
- Department of Physiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Shigeyuki Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Masaharu Noda
- Division of Molecular Neurobiology, National Institute for Basic Biology, Okazaki, Aichi 444-8787, Japan; School of Life Science, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Aichi 444-8787, Japan; Research Center for Cell Biology, Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Kanagawa 226-8503, Japan.
| |
Collapse
|
46
|
Cole NI, Suckling RJ, Desilva V, He FJ, MacGregor GA, Swift PA. Serum sodium concentration and the progression of established chronic kidney disease. J Nephrol 2018; 32:259-264. [PMID: 30328093 PMCID: PMC6422977 DOI: 10.1007/s40620-018-0541-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 09/29/2018] [Indexed: 02/05/2023]
Abstract
Background Higher serum sodium concentration has been reported to be a risk factor for the development of incident chronic kidney disease (CKD), but its relationship with the progression of established CKD has not been investigated. We hypothesised that increased serum sodium concentration is a risk factor for estimated glomerular filtration rate (eGFR) decline in CKD. Methods This was a retrospective cohort study using data collected over a 6-year period, with baseline data obtained during the first 2 years. We included patients known to our renal service who had had a minimum of three blood tests every 2 years and an eGFR of < 60 mL/min/1.73 m2 at baseline. Exclusion criteria were renal replacement therapy, diabetes mellitus, heart failure and decompensated liver disease. A multiple linear regression model investigated the relationship between baseline serum sodium and eGFR decline after adjustment for confounding factors. Results 7418 blood results from 326 patients were included. There was no relationship between serum sodium concentration and estimated glomerular filtration rate at baseline. After multivariable adjustment, a 1 mmol/L increase in baseline serum sodium was associated with a 1.5 mL/min/1.73 m2 decline in eGFR during the study period (95% CI 0.9, 2.0). A reduction in eGFR was not associated with significant changes in serum sodium concentration over 6 years. Conclusion Higher serum sodium concentration is associated with the progression of CKD, independently of other established risk factors. Conversely, significant alterations in serum sodium concentration do not occur with declining kidney function.
Collapse
Affiliation(s)
- Nicholas I Cole
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK.
| | - Rebecca J Suckling
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK
| | - Vipula Desilva
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK
| | - Feng J He
- Wolfson Institute of Preventative Medicine, Queen Mary University of London, London, UK
| | - Graham A MacGregor
- Wolfson Institute of Preventative Medicine, Queen Mary University of London, London, UK
| | - Pauline A Swift
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK
| |
Collapse
|
47
|
Bkaily G, Simon Y, Menkovic I, Bkaily C, Jacques D. High salt-induced hypertrophy of human vascular smooth muscle cells associated with a decrease in glycocalyx. J Mol Cell Cardiol 2018; 125:1-5. [PMID: 30321538 DOI: 10.1016/j.yjmcc.2018.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 10/28/2022]
Abstract
All health organizations agree that, presently, the average daily salt (sodium chloride) consumption per person has attained almost double the recommended amount. A chronic high salt diet contributes to the increase in blood pressure and to the development of cardiovascular disease. Although our knowledge of hypertension, in general, is abundant, little is known about salt-sensitive hypertension. Here we tested the hypothesis that acute and/or chronic high salt mimicking that present in high-salt sensitive hypertensive patients may induce hypertrophy of human vascular smooth muscle cells (hVSMCs) and their nuclei that are associated with damage to the plasma membrane glycocalyx. Using quantitative 3D confocal microscopy coupled to immunofluorescence techniques, we tested the effects of acute (2-4 days) and chronic (6-16 days) treatments of hVSMCs without (145 mM) or with high (149 mM) extracellular sodium chloride. Our results showed that acute treatment with high salt significantly decreased the relative density of membrane glycocalyx without affecting the whole cell and nuclear volumes of hVSMCs. However, chronic treatments with high salts induced significant decreases in the relative density of glycocalyx accompanied by significant increases in the whole cell and nuclear volumes as well as in the protein/DNA ratio. The high salt-induced hVSMC hypertrophy was associated with a sustained increase in intracellular sodium and calcium. Our results clearly showed that, increasing salt concentration by as little as 4 mM immediately induced damage to the cell membrane glycocalyx leading to chronic Na+ and Ca2+ overloads and hVSMC hypertrophy. The latter may reduce the lumen of arteries leading to an increase in blood pressure. Future identification of the mechanisms that are implicated in a high salt-induced remodeling of hVSMCs may permit the development of new therapeutic interventions for the treatment of high salt-sensitive hypertension and the prevention of the associated cardiovascular diseases.
Collapse
Affiliation(s)
- Ghassan Bkaily
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada.
| | - Yanick Simon
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada
| | - Istok Menkovic
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada
| | - Carl Bkaily
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada
| | - Danielle Jacques
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada
| |
Collapse
|
48
|
Kanbay M, Aslan G, Afsar B, Dagel T, Siriopol D, Kuwabara M, Incir S, Camkiran V, Rodriguez‐Iturbe B, Lanaspa MA, Covic A, Johnson RJ. Acute effects of salt on blood pressure are mediated by serum osmolality. J Clin Hypertens (Greenwich) 2018; 20:1447-1454. [PMID: 30232829 PMCID: PMC8030773 DOI: 10.1111/jch.13374] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/06/2018] [Accepted: 07/15/2018] [Indexed: 02/06/2023]
Abstract
It is classically thought that it is the amount of salt that is critical for driving acute blood pressure responses. However, recent studies suggest that blood pressure responses, at least acutely, may relate to changes in serum osmolality. Here, we test the hypothesis that acute blood pressure responses to salt can be altered by concomitant water loading. Ten healthy patients free of any disease and medication underwent 4 interventions each a week apart in which they took 300 mL of lentil soup with no salt (visit 1), lentil soup with 3 g salt (visit 2), or lentil soup with 3 g salt and 500 mL water (visit 3) or 750 mL water (visit 4). At each visit, hourly blood measurements and blood pressure measurements (baseline, 1st, 2nd, 3rd, and 4th hour) were performed and plasma osmolarity, sodium and copeptin levels were measured. Patients receiving the 3 g salt showed a 6 mOsm/L change in osmolality with a 2.5 mmol/L change in plasma sodium and 10 mm Hg rise in systolic blood pressure at 2 hours. When the same patients drank salty soup with water, the changes in plasma osmolarity, plasma sodium, and blood pressure were prevented. The ability to raise blood pressure acutely with salt appears dependent on changes in plasma osmolality rather than the amount of salt. Our findings suggest that concurrent intake of water must be considered when evaluating the role of salt in blood pressure.
Collapse
Affiliation(s)
- Mehmet Kanbay
- Division of Nephrology, Department of MedicineKoc University School of MedicineIstanbulTurkey
| | - Gamze Aslan
- Department of CardiologyKoc University HospitalIstanbulTurkey
| | - Baris Afsar
- Division of Nephrology, Department of Internal MedicineSuleyman Demirel University School of MedicineIspartaTurkey
| | - Tuncay Dagel
- Division of Nephrology, Department of MedicineKoc University School of MedicineIstanbulTurkey
| | - Dimitrie Siriopol
- Department of NephrologyUniversity of Medicine and Pharmacy "Gr. T. Popa"lasiRomania
| | - Masanari Kuwabara
- Division of Renal Diseases and Hypertension, School of MedicineUniversity of Colorado DenverAuroraColorado
- Department of CardiologyToranomon HospitalTokyoJapan
| | - Said Incir
- Department of BiochemistryKoc University HospitalIstanbulTurkey
| | - Volkan Camkiran
- Department of CardiologyKoc University HospitalIstanbulTurkey
| | - Bernardo Rodriguez‐Iturbe
- Instituto Venezolano de Investigaciones CientÍficas (IVIC‐Zulia), Nephrology Service Hospital Universitario, Universidad del ZuliaMaracaiboVenezuela
| | - Miguel A. Lanaspa
- Division of Renal Diseases and Hypertension, School of MedicineUniversity of Colorado DenverAuroraColorado
| | - Adrian Covic
- Department of NephrologyUniversity of Medicine and Pharmacy "Gr. T. Popa"lasiRomania
| | - Richard J. Johnson
- Division of Renal Diseases and Hypertension, School of MedicineUniversity of Colorado DenverAuroraColorado
| |
Collapse
|
49
|
The association between serum sodium concentration, hypertension and primary cardiovascular events: a retrospective cohort study. J Hum Hypertens 2018; 33:69-77. [DOI: 10.1038/s41371-018-0115-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/07/2018] [Accepted: 08/24/2018] [Indexed: 12/31/2022]
|
50
|
Armanini D, Bordin L, Dona' G, Andrisani A, Ambrosini G, Sabbadin C. Relationship between water and salt intake, osmolality, vasopressin, and aldosterone in the regulation of blood pressure. J Clin Hypertens (Greenwich) 2018; 20:1455-1457. [PMID: 30232837 DOI: 10.1111/jch.13379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Decio Armanini
- Department of Medicine - Endocrinology (DIMED), University of Padua, Padua, Italy
| | - Luciana Bordin
- Department of Molecular Medicine - Biological Chemistry, University of Padua, Padua, Italy
| | - Gabriella Dona'
- Department of Molecular Medicine - Biological Chemistry, University of Padua, Padua, Italy
| | | | - Guido Ambrosini
- Department of Women's Health-Salus Pueri, University of Padua, Padua, Italy
| | - Chiara Sabbadin
- Department of Medicine - Endocrinology (DIMED), University of Padua, Padua, Italy
| |
Collapse
|